Today’s Factismal: The first mass outbreak of the “Spanish flu” appeared in America on March 11, 1918; by the time the pandemic was finished, it would sicken 20% of the world’s population and kill more than 50 million people.
An outbreak of a disease is a hard thing to define. Only rarely can scientists point their fingers at one person or one event and say “That’s what did it; there is patient zero”. But the 1918 pandemic of influenza that came to be known as the “Spanish flu” is one of those rare instances.
On the morning of March 11, 1918, at Fort Riley, Kansas, two men reported to the camp infirmary for “bad colds”. By that evening, more than 100 men would be ill. Within a month, more than a thousand men would come down with the flu in that camp alone, and instances of the disease would be recorded in Queens, in San Francisco, and in Florida. Though there had been a few scattered instances of the flu earlier in the year, this was the first mass outbreak and was just a taste of what was to come.
In August, things got worse. An even more virulent strain of the flu appeared. This new version was more easily transmitted and deadlier than the earlier version. About the only saving grace was that those who had already become ill were immune to the new strain. Nevertheless, by the end of the year the flu had spread across the globe. Cases were reported in China, Japan, Australia, South America, Africa, and across Europe. But because the world was at war, only neutral countries like Spain allowed newspapers to print articles about the disease’s ravages. As a result, the 1918 influenza pandemic became known popularly as the “Spanish flu”.
The 1918 virus was unusual in several ways. Though the flu is always fairly easily transmitted (which is why doctors recommend “vampire sneezes” and staying home when you feel even slightly ill) , this strain was particularly aggressive. Where a typical flu will infect perhaps 5% of the population, more than 30% of the world’s population came down with the 1918 flu; that’s 600 million people, or nearly twice today’s population of the USA. (If it happened today, there would be more than two billion people sick, or the equivalent of the entire population of China and India combined.) And where a typical flu outbreak kills perhaps one person in every thousand victims, this one killed nearly two hundred. (Today, that would mean that more than 425 million people would die.) The odds were even worse for pregnant women; perhaps seven hundred out of every thousand of them died and another seventy-five survived but lost their babies. As a result, an estimated 50,000,000 people died. That’s more than were killed during World War I!In one year, this flu killed more people than the Black Death did in a century.
But the oddest thing about the flu was that instead of killing the young and elderly, as most flus do, this one primarily killed people between 20 and 40 years old. Most flus kill by weakening the patient, who then is infected with pnuemonia or some other secondary infection which is the proximate cause of death. This one caused the body’s own immune system to rebel, leading to a “cytokine storm” where the victim’s own immune system turned against him.
The pandemic led to panic and fear as time went on. Witnesses reported bodies stacked like cordwood, waiting burial, and tent cities of the ill and dying. Some towns closed their borders in vain attempts to stop the spread of the disease. People everywhere wore masks and took patent medicines in hopes that these feeble measures would protect them from the disease’s ravages. But it wasn’t until the disease had finally run its course and run out of potential victims before it finally died away.
Though few outside of the medical profession remember the disease today, scientists are always on the alert for another pandemic. You may remember the 2009 “swine flu“, which was a close relative of the 1918 strain and killed some 18,000 people before a combination of improved vaccines and medical treatments stopped it. Unfortunately, that virus (or a near relative) is back and as deadly as ever. That constant danger is why the CDC always urges people to get the annual influenza vaccine and why they track cases of the flu so closely.
If you’d like to help them, then consider going to the Health Tracking Network and letting them know when you or someone you know fall ill. Though this may not be the year that we get the next 1918 pandemic, you can never be too sure.